Children and adolescents with chronic diseases have high rates of overweight and obesity which often exceeds those observed in typically developing populations. Interventions including a dietary component play an important role in weight management. The aim of this systematic literature review is to therefore determine which interventions that include a dietary component are effective at treating overweight and obesity in children and adolescents with chronic diseases.
Six databases were searched and two independent reviewers assessed articles against the eligibility criteria. Key eligibility criteria included studies that included overweight or obese children or adolescents (≤18 years) with a chronic disease and that implemented a weight management intervention including a dietary component. Interventions could be diet-only or be multicomponent delivered alongside physical activity, behavioural therapy or drugs. Primary outcomes were body mass index (BMI) as absolute (kg/m2) or z-score values and weight.
The literature search identified 9872 references from which 19 studies were included. Nine studies were randomised controlled trials (RCTs) and ten were before and after comparisons. A high risk of bias was detected across studies. Participant diagnosis included polycystic ovarian syndrome (PCOS), asthma, survivors of cancers, intellectual and developmental disabilities, Prader-Willi syndrome and chronic migraine. A meta-analysis comparing pre- and post-intervention values demonstrated a small but significant impact of dietary (diet-only or multicomponent) interventions on BMI (SMD -0.39 [95% CI -0.59, -0.18]).
Interventions including a dietary component may have a small effect on BMI for overweight or obese children and adolescents with chronic diseases. However, more evidence is required to confirm this effect as this review was limited by the variability of study designs and a high risk of bias. It remains unclear which combination of diet and other lifestyle and drug components are most effective at treating overweight and obesity in youth with chronic diseases.